Dermatitis atopic, tacrolimus efficacy

The evidence of the safety and efficacy of pimecrolimus was derived from studies primarily in patients with mild-to-moderate atopic dermatitis tacrolimus data was derived from moderate-to-severe patients. 

Ashcroft DM, Dimmock P, Garside R, Stein K, Williams HC. Efficacy and tolerability of topical pimecrolimns and tacrolimus in the treatment of atopic dermatitis meta-analysis of randomised controlled trials. BMJ 2005 330 516-21. 

Jablonska S, Rustin M. Safety and efficacy of 1 year of tacrolimus ointment monotherapy in adults with atopic dermatitis. The European Tacrolimus Ointment Study Group. Arch Dermatol 2000 136(8) 999-1006. 

Kang S, Lucky AW, Pariser D, Lawrence I, Hanifin JM. Long-term safety and efficacy of tacrolimus ointment for the treatment of atopic dermatitis in children. J Am Acad Dermatol 2001 44(Suppl l) S58-64. 

Pimecrolimus and tacrolimus are calcineurin inhibitors capable of exerting a local immunomodulating effect that may serve to normalize hyperproliferation of epidermis. As topical agents, tacrolimus and pimecrolimus are approved for the treatment of atopic dermatitis however, regulatory approval regarding the efficacy of these agents in psoriasis is yet to be completed. 

The role of both T and B lymphocytes in a variety of disease states beyond transplantation has become increasingly important in the past decade. This is especially true of those diseases frequently referred to as autoimmune in their etiology, such as rheumatoid arthritis, nephrotic syndrome, systemic lupus erythematosus, inflammatory bowel disease, and so on. In addition, several other major diseases are also known to have a component of T- or B-cell-mediated pathogenesis, for example, atopic dermatitis, psoriasis, and asthma. Until very recently, the mainstay of therapy for these diseases was the corticosteroids, which were often less than satisfactory in efficacy and often associated with undesirable side effects, especially in growing children and the elderly. Thus, the search for new agents with different mechanisms of action and which did not have the same adverse event profile as conventional corticosteroids led to the subsequent evaluation of drugs such as tacrolimus and sirolimus to treat several of these diseases. 

Hanifin, J. M., Ling, M. R., Langley, R., Breneman, D., and Rafal, E., and the Tacrolimus Ointment Study Group (2001). Tacrolimus ointment for the treatment of atopic dermatitis in adult patients Part 1, Efficacy. J. Am. Acad. Dermatol. 44, S28-S38. 

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterised by extreme pruritus and lichenified papules and plaques that may begin in or persist in to adulthood. Topical corticosteroids are first-line prescription therapy for AD they are efficacious and have a well established safety profile. The topical calcineurin inhibitors tacrolimus and pimecrolimus have been approved as second-line topical therapy for AD. The current review evaluates the available studies on the comparative effectiveness, safety, cost, and impact on quality of life of topical corticosteroids and topical calcineurin inhibitors for the treatment of adult AD [17 ]. 

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